Should the U.S. Import Drugs to Drive Down Costs?

Tim Wu is right about the problem, but his solution is not a good one.

The federal government is finally putting in place a “track and trace” system to secure the pharmaceutical supply chain. Assurance of product identity and safety (and protection from counterfeiting) is at risk with importation outside a regulated supply system.

Canada’s drugs are cheaper than ours because its single-payer health care system negotiates prices. Our government is forbidden by law from doing so (for the Medicare and Medicaid programs). Repeal would have immediate significant impact.

A longer range solution, in the generic drug area, would be for a well-funded nonprofit to go into the generic drug business. Competition would drive down prices; the nonprofit could use its reasonable profits to support its health mission.

This solution requires legislation to mandate that the Food and Drug Administration speedily approve any sound generic drug application from a nonprofit for a drug whose price has risen sharply. The threat of drawing quick competition, as well as that competition itself, would be effective.

MARSHA COHEN, SAN FRANCISCO

The writer teaches food and drug law at U.C. Hastings College of the Law.

To the Editor:

Tim Wu’s call to open the American market to foreign drug supplies is cavalier in its dismissal of the safety risks of his proposal, and wildly optimistic about the potential savings such a move would create.

A bipartisan group of four former commissioners of the Food and Drug Administration wrote to Congress recently expressing concern over the idea. Such a move, they wrote, “is likely to harm patients and consumers and compromise the carefully constructed system that guards the safety of our nation’s medical products.”

How about the purported savings? A Department of Health and Human Services task force on importation found that “total savings to drug buyers from legalized commercial importation would be 1 to 2 percent of total drug spending and much less than international price comparisons might suggest.” The task force wrote, “The savings going directly to individuals would be less than 1 percent of total spending.”

There is no silver bullet for rising health costs. But exposing American patients to potentially counterfeit, unapproved or adulterated drugs — for what would probably be scant savings — is not the answer.

JIM GREENWOOD, WASHINGTON

The writer is president and chief executive of the Biotechnology Innovation Organization.